Americans less healthy th...( lar in both countries with about one i...),Health

lar in both countries, with about one in five people between the ages of 55 and 64 years currently smoking. Obesity rates were much higher in the U.S. and heavy drinking was more common in England. In both countries, disease prevalence was much higher among individuals of lower income and education, compared with those at higher income and education levels. Differences in socioeconomic groups between the two countries were so great that those in the top education and income level in the U.S. had similar rates of diabetes and heart disease as those in the bottom education and income level in England.

"Although access to health care is important, differential access can only offer a partial explanation for our findings," the authors write. " health insurance cannot be the central reason for the better health outcomes in England because the top socioeconomic status (SES) tier of the U.S. population have close to universal access but their health outcomes are often worse than those of their English counterparts."

"Two simple but powerful conclusions follow from our comparisons using biological and self-reports of disease in England and the United States. First, Americans are much sicker than the English. Second, the SES-health gradient is also not a reporting mirage Instead, the SES-health gradient appears with equal force in either self-reports or biological measures of health."

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Contact: Michael Marmot, M.D.
m.marmot@ucl.ac.uk
JAMA and Archives Journals
2-May-2006

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